Registration/Scheduling Representative | Call Center

Clarke County Hospital•Osceola, IA

1d•Onsite

About The Position

This role is responsible for a variety of tasks primarily related to communication and reception activities within the call center, while maintaining positive patient relations. The Registration/Scheduling Representative will greet and direct patients and visitors, answer and transfer telephone calls, and screen calls by urgency. A key part of the role involves receiving and interviewing patients to gather and verify demographic and insurance information for electronic health records and insurance claim processing. This includes scheduling, preregistering, canceling, and rescheduling tests and procedures, ensuring they meet medical necessity and patient needs. The representative will also educate patients on insurance benefits, arrange for payment of co-pays and deductibles, collect payments, and reconcile daily receivables. Additionally, the role involves obtaining patient information from other offices, coordinating scheduled exams, educating external practitioners, compiling personal, insurance, and financial information, and providing necessary forms to billing and other departments. Communication and coordination with internal departments and external offices are crucial. The position also supports new employee orientation/training, conducts audits of the scheduling system, and participates in developing new procedures and processes. Maintaining computer master files and required records is also a responsibility. The role requires critical thinking, accuracy, and a proactive approach to continuous quality improvement, adhering to all hospital policies and guidelines.

Requirements

Previous experience with data entry, communication systems and computers is preferred.
Previous general/medical office experience is preferred.
Previous experience with an electronic health record or medical office software is preferred.
Previous insurance knowledge is preferred.
Previous experience operating office equipment to include: computer, fax machines, printer/copier and windows based computer software.
Ability to demonstrate strong customer service skills – being customer/patient focused.
Attention to detail/accuracy in work.
Communication skills.
Computer skills.
Social skills.
Basic math and Critical thinking skills.
Maintain strict confidentiality of information related to patients.
Insurance skills.
Must be able to work effectively under stressful situations.
Ability to understand and apply guidelines, policies and procedures.
Ability to interact effectively with physicians, health care team members, individuals and members of their support team.
Writes, reads, comprehends and speaks fluent in English.
Multicultural sensitivity.

Nice To Haves

High School Diploma or equivalent preferred

Responsibilities

Greets and directs all patients, visitors, sales representatives, etc., who need assistance to the appropriate department and/or staff member using AIDET.
Answers/transfers telephone calls in a clear, calm and professional manner.
Screens calls by urgency and routes calls promptly, accurately and professionally to appropriate party.
Performs a wide variety of tasks primarily related to communication and reception activities while maintaining positive patient relations.
Is receptive to the needs of patients in such a manner as to promote a favorable public image of Clarke County Hospital.
Receives and interviews patient or responsible individual to gather, verify and enter demographic and insurance information necessary for completion of electronic health record and insurance claim processing at each patient visit in electronic health record.
Schedules, preregisters, cancels, reschedules tests and procedures for clinics and hospital and coordinates scheduling of tests and procedures to assure they meet medical necessity, patient, department and practitioner needs while maintaining appointment schedule according to department procedure.
Ensure the patient or guardian understands and signs consent, insurance and other required forms.
Receives, transcribes, schedules and scans practitioner orders into electronic record daily.
Enters reason for tests/procedure to meet medical necessity and refers to UR for further review if needed.
Refers tests/procedures to UR that need prior authorization.
Verifies insurance benefits with insurance companies via phone calls, faxes or internet and documents verification in each patient record, as appropriate.
Educate patient/guarantor regarding insurance benefits; making arrangements for payment of co-pays, co-insurance and/or deductibles.
Assist with financial counseling on self-pays.
Collect payments, issue receipts and reconcile daily receivable activity.
Responsible for obtaining patient information from other practitioner offices for scheduling and assigns time for exams.
Coordinates scheduled exams with mobile and contracted companies.
Educates outside practitioners and office staff as to ordering outpatient services at CCH.
Compile and distribute information regarding personal, insurance and financial status.
Provide appropriate forms to billing and other departments.
Communicates and coordinates services with internal departments and internal and external practitioner office staff.
Assists in orientation/training of new employees.
Conducts audits of the scheduling system to ensure standards are being met when requested.
Actively participates in developing plans to implement new procedures and processes – working collaboratively with other departments, practitioners and contract services.
Review and maintain appropriate computer master files: patient master data, guarantor, physician and insurance as well as correlating appropriate manuals.
Maintain all required records, reports, statistics, etc.
Demonstrates creative, critical thinking skills.
Focus daily work toward high customer satisfaction.
Maintain regular and consistent attendance at work.
Participates in departmental, organizational and mandatory meetings, educational e-mails, etc.
Actively participates in team oriented decision making process.
Is a team player, willing to be flexible and open to ideas of others.
Requires a high degree of accuracy.
Ability to recognize and correct discrepancies.
Develop a proactive mind set towards the job.
Observes opportunities for improvement, formulates ideas, communicates those ideas with their supervisor and/or other staff, and carries out variations in work habits in continuous quality improvement.
Completes all annual education and competency requirements within the calendar year.
Demonstrates Clarke County Hospital Standards of Behaviors as well as adheres to hospital and department policies and procedure, infection control, quality assurance, compliance and safety guidelines.
Reports conduct that is known or suspected to be illegal or in violation of the organizations policies and procedures.
Brings any questions or concerns regarding compliance to the immediate attention of manager.